Report Title:

QUEST Medical Assistance Program

Description:

Enables DHS to pay for QUEST services at federally qualified health centers at a rate not less than the amount paid to other providers in the same geographic area for comparable services. Appropriates funds.

HOUSE OF REPRESENTATIVES

H.B. NO.

67

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO QUEST MEDICAL ASSISTANCE PROGRAM.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that:

(1) It is in the best interest of the State to ensure access to primary and preventive health care to its residents that not only results in a healthier and more productive population, but also reduces the amount of public funds to support the costs for hospitals and emergency rooms to treat preventable conditions;

(2) Certain individuals covered by the QUEST medical assistance program are not receiving timely and appropriate medical treatment and require additional clinical and supportive services to improve their health;

(3) Hawaii's system of nonprofit community-based health centers has expertise in caring for those with cultural and socioeconomic barriers to receiving proper care;

(4) The health centers contribute greatly to the economy and livability of the depressed areas they serve by, directly or indirectly, adding $85,600,000 and one thousand one hundred jobs annually to the local economy;

(5) The health centers are essential to the State as the health care safety net for an increasing number of uninsured residents;

(6) Because the State no longer pays health centers what it costs to provide service to patients covered by QUEST, state and federal subsidies are needed to cover the resulting shortfalls. Additional subsidies are needed to pay for services to the uninsured; and

(7) Almost fifty-four per cent of the dollars spent to increase QUEST payments to community health centers are matched by the federal government.

The purpose of this Act is to maximize the availability of federally matchable funds to ensure the viability and sustainability of the nonprofit community health center system of care for the uninsured, persons covered by QUEST, and others who need special access and supportive services.

SECTION 2. Contracts entered into by the department of human services with any health plan at each federally qualified health center and rural health center for the provision of QUEST services to enrollees shall provide for payments comparable to but not less than the amount the plan pays to other providers in the same geographic area for comparable services.

At least quarterly, the department of human services shall pay the federally qualified health center or rural health center the difference between the capitation or fee for service payments received by the center from the health plan and the reasonable cost incurred by the center in providing the service.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1, or so much thereof as may be necessary for fiscal year 2003-2004, and the same sum, or so much thereof as may be necessary for fiscal year 2004-2005, to maximize the availability of federally matched funds to ensure the viability and sustainability of the nonprofit community heath center system of care for the uninsured, persons covered by QUEST, and others who need special access and supportive services.

The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2003.

INTRODUCED BY:

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